ABSTRACT
Ingestion of caustic material often produces profound and irreversible pathologic
changes that require reconstructive surgery of the organs damaged. This report describes
the authors' successful experience with microsurgical techniques that allowed adequate
reconstruction in three patients with cicatricial contracture of the oral cavity and
esophagus following ingestion of caustic substances.
All patients had attempted suicide by ingesting liquid alkali. Patients #1 and #2
complained of limited mouth opening and impaired tongue movement due to oral scar
contracture. Contracture release in the first patient resulted in a defect from the
anterior border of the mandible to the retromolar region. The defect was resurfaced
with a 6 - 12 cm free forearm flap. Release of the scar contracture in the second
patient resulted in a long, narrow, tortuous defect that was difficult to cover, even
with a forearm flap, and a jejunal segment was microsurgically transferred as a patch
graft to reconstruct the defect. Patient #3 had dysphagia due to stricture of the
cervical portion of the esophagus. The defect after resection of the cervical portion
was reconstructed by free jejunal interposition.
Appropriately selected free-flap transfer in each case provided a satisfactory restoration
of function of the oropharyngeal and digestive passages.
